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Preoperative versus postoperative chemoradiotherapy in stage T3, N0 rectal cancer

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Abstract

Background

The study populations of previous preoperative chemoradiotherapy (pre-CRT) studies have consisted of mixed clinical stages, such as cT3-cT4 and/or cN positive. For this reason, it has not been possible to demonstrate whether pre-CRT is of benefit for individual subgroups.

Methods

The medical records of 137 rectal cancer patients with clinical stage T3, N0 disease who received either pre-CRT or postoperative chemoradiotherapy (post-CRT) between 2002 and 2011 were retrospectively analyzed. The regimen of pre-CRT consisted of slow fluorouracil (5FU) infusion and that of post-CRT consisted of bolus 5FU and leucovorin concurrent with radiation.

Results

Following pre-CRT, significant downstaging was achieved. However, administration of pre-CRT did not influence the type of surgical resection in tumours ≤5 cm distant from the anal verge (p = 0.14). Pathological complete response was achieved in 16 % of the patients in the pre-CRT group. The local recurrence rate (LRR) at 5 years was 5.7 % in the pre-CRT and 11.1 % in the post-CRT groups (p = 0.04). The distant recurrence rate (DRR) at 5 years was 76 % and 77 % in the pre-CRT and post-CRT groups, respectively (p = 0.1). Overall survival was similar in two groups (74.8 % vs. 75.3 %, p = 0.3).

Conclusions

The treatment of stage T3, N0 rectal cancer patients with pre-CRT followed by surgery decreased LRR, but did not improve DRR or OS as compared with surgery followed by post-CRT in our patient cohort.

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Conflict of interest

The authors have indicated no conflicts of interest.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Internal Medicine, Medical Faculty, Akdeniz University, 7058, Antalya, Turkey

    Deniz Tural

  2. Department of Medical Oncology, Sisli Education and Research Hospital, Istanbul, Turkey

    Fatih Selcukbiricik

  3. Division of Medical Oncology, Department of Internal Medicine, Medical Faculty, Medipol University, Istanbul, Turkey

    Özcan Yıldız

  4. Department of Radiation Oncology, Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey

    Olgun Elcin

  5. Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Sibel Erdamar

  6. Department of Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Sabri Güney

  7. Division of Medical Oncology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Fuat Demireli, Evin Büyükünal & Süheyla Serdengeçti

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  1. Deniz Tural
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  2. Fatih Selcukbiricik
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Correspondence to Deniz Tural.

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Tural, D., Selcukbiricik, F., Yıldız, Ö. et al. Preoperative versus postoperative chemoradiotherapy in stage T3, N0 rectal cancer. Int J Clin Oncol 19, 889–896 (2014). https://doi.org/10.1007/s10147-013-0636-4

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  • DOI: https://doi.org/10.1007/s10147-013-0636-4

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